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F218
Reference ranges for the linear dimensions of the
intracranial ventricles in preterm neonates
M W Davies, M Swaminathan, S L Chuang, F R Betheras
Abstract
Aims—To establish normal ranges, in pre-
term infants < 33 weeks’ gestation, for
measurements of the lateral, third, and
fourth ventricles and to assess intra-
observer and inter-observer reliability. To
assess the eVect of head position during
scanning on lateral ventricle size. To
determine whether sex influences ventri-
cle size.
Methods—A prospective study involving
infants < 33 weeks’ gestational age (GA) at
birth. Cranial ultrasound scans were done
during the first 3 days of life. Linear
dimensions of the anterior horn width and
thalamo-occipital distance of the lateral
ventricles, the width of the third ventricle,
and the width and length of the fourth
ventricle were measured. Measurements
were plotted against GA and reference
ranges produced. All measurements were
tested for intra-observer and inter-
observer reliability. Head position and sex
diVerences were studied.
Results—120 infants with known GA (23+1
to 32+6 weeks) had their intracranial
ventricles measured. Reference ranges
obtained were—anterior horn width:
0–2.9 mm; thalamo-occipital distance:
8.7–24.7 mm; third ventricle width:
0–2.6 mm; fourth ventricle width: 3.3–7.4
mm; fourth ventricle length: 2.6–6.9 mm.
Dependent and non-dependent lateral
ventricles did not diVer significantly in
size. There was no clinically significant
diVerence in ventricular size between
sexes.
Conclusions—Reference ranges for the
measurement of the intracranial ventri-
cles in preterm infants from 23 to 33
weeks’ GA are provided and can be used in
the diagnosis and assessment of ventricu-
lar enlargement in preterm infants. All
measurements have good intra-observer
Division of Neonatal and inter-observer reliability. Head posi-
Services, Royal
tion at the time of scanning does not influ-
Women’s Hospital,
Melbourne 3053, ence the asymmetry of the lateral ven-
Australia tricular measurements. The infant’s sex
M W Davies
does not influence ventricular size.
M Swaminathan (Arch Dis Child Fetal Neonatal Ed 2000;82:F218–F223)
S L Chuang
F R Betheras
Keywords: preterm infants; cranial ultrasound; ven-
Correspondence to: tricular measurement; reference range
Dr M W Davies, Perinatal
Research Centre, The Royal
Women’s Hospital, Bowen
Bridge Road, Herston, Ultrasonography is a well established, non-
Brisbane, QLD 4029,
Australia invasive diagnostic tool used in neonatal inten-
email: mwdavies@ sive care units to measure intracranial ventricu-
ozemail.com.au
lar size.1 Quantitative measures of ventricular
Accepted 28 October 1999 size are superior to any subjective assessment.2
Arch Dis Child Fetal Neonatal Ed 2000;82:F218–F223
Numerous methods to measure ventricular size
in newborns have been published.3–11 Data on
the dimensions of the anterior horn and body
of the lateral ventricles are widely available for
preterm newborns. However, there are no
reference data available on the linear dimen-
sions of the occipital horns of the lateral ventri-
cle or the third and fourth ventricles in preterm
infants.1 In addition, intra-observer and inter-
observer reliability have not been well investi-
gated for any ventricular measurement. The
aims of our study were to: (1) establish normal
value ranges, in preterm infants less than 33
weeks’ gestation, for measurements of the
lateral, third, and fourth ventricles; (2) assess
intra-observer and inter-observer reliability for
all ventricular measurements; (3) assess the
eVect of head position during the scan on
lateral ventricle size; and (4) determine
whether sex influences ventricle size.
Methods
This was a prospective study involving infants
born from 8 December 1997 to 28 August
1998. In our unit, routine cranial ultrasound
scans are done on all infants < 1500 g
birthweight and/or less than 33 weeks’
gestational age on days 1, 3, 7, and 28. All
infants less than 33 weeks were eligible for our
study. Infants were excluded if the gestational
age was not known, if there was any craniospi-
nal malformation, or if there was grade 3 or 4
intraventricular haemorrhage according to the
classification of Papile et al.12 Measurements
were taken from the first cranial scan done
within the first 3 days of life. The gestational
age assessment was based upon an early
pregnancy scan (< 18 weeks’ gestational age)
or by certain dates (date of last menstrual
period) if no antenatal scan was performed.
Cranial ultrasound scans were done with a
General Electric LOGIQ 500 scanner (GE
Medical Systems, Waukesha, USA) with a
7 MHz curvilinear sector probe (GE LOGIQ;
C721). The scans were done by one of the four
authors and each scan was subsequently
validated by the senior sonologist (FRB). The
infant’s head was not moved from its original
resting position when first approached to be
scanned. The resting position of the infant’s
head was noted as either right side up, left side
up, or face up. The methods for measuring
each intraventricular dimension are described
below. All ventricular measurements were
taken with calipers placed at the junction of the
ependymal lining and ventricular cavity. Figure
1 shows the caliper position and alignment for
all measurements.
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Reference ranges for intracranial ventricles in preterm neonates F219

A B

C D

Figure 1 A line drawing showing the measurements made

on the ultrasound images in figs 2–5 (A–D, respectively), Figure 3 A parasaggital section of the brain on
with arrows indicating the correct caliper position and ultrasound showing measurement of the thalamo-occipital
alignment. distance of the lateral ventricle.

Figure 2 A coronal section of the brain on ultrasound Figure 4 A transverse section of the brain on ultrasound
showing measurement of the anterior horn width of the showing measurement of the width of the third ventricle.
lateral ventricles.
THE ANTERIOR HORN WIDTH
The width of the anterior horn of the lateral
ventricles was measured in a coronal view, with
the plane of the scan at the level of the
interventricular foramina of Monro (just ante-
rior to the choroid plexus in the third
ventricle). The width was measured on each
side as the distance between the medial wall
and floor of the lateral ventricle at the widest
point (figs 1A and 2).5 13

THE THALAMO-OCCIPITAL DISTANCE

This measurement was taken in the oblique
parasagittal view, which demonstrated the
entire lateral ventricle with the anterior horn,
the atrium, and the temporal and occipital
horns (to its maximal extent) all in view. The
thalamo-occipital distance was then measured
from the outermost point of the thalamus, at its
junction with the choroid plexus, to the outer-
most part of the occipital horn posteriorly (figs
1B and 3).
THE THIRD VENTRICLE WIDTH
The measurement of the third ventricle was
taken in the axial plane between the thalami
and in line with the foramina of Monro (at the
level just above a line from the outer canthus of
the eye to the upper point of insertion of the
ear). The measurement was taken from inner
edge to inner edge (figs 1C and 4).
THE FOURTH VENTRICLE WIDTH AND LENGTH
The fourth ventricular width and length were
measured in an oblique/transverse plane
through the posterior fossa using the asterion
Figure 5 An oblique/transverse section of the cerebellum
on ultrasound showing measurement of the width and
length of the fourth ventricle.
as the acoustic window. The asterion is the
junction of the parieto-occipital and lambdoid
sutures and is palpable just behind the pinna of
the ear. This plane is parallel and posterior to
the longitudinal plane of the brainstem,
producing a triangular view of the fourth
ventricle through the lateral recesses. The
width of the fourth ventricle is the distance
between the lateral recesses and forms the base
of the triangle, posterior to which is the
cerebellar vermis. The length of the fourth
ventricle is the distance from the base to the
apex, which is the end of the cerebral aqueduct.
The lateral walls are formed by the cerebellar
peduncles (figs 1D and 5).
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F220 Davies, Swaminathan, Chuang, Betheras

Table 1 Mean (SD) ventricular measurements according to sex early pregnancy scan (< 18 weeks’ gestational
age) in 108 (90%) cases or by certain dates
Measurement (mm) Girls Boys p Value
(date of last menstrual period) in 12 (10%)
Anterior horn width 1.22 (0.85) 1.30 (0.79) 0.44 cases if no antenatal scan was performed. One
Thalamo-occipital distance 15.6 (3.4) 17.5 (4.3) 0.0002
Third ventricle width 0.99 (0.36) 1.12 (0.93) 0.3 hundred and five babies were excluded because
Fourth ventricle width 5.30 (1.07) 5.42 (1.00) 0.56 of: uncertain gestation (14), congenital malfor-
Fourth ventricle width 4.73 (1.15) 4.75 (1.06) 0.92
mation (three), or grade 3 or 4 intraventricular
haemorrhage (four). A further 84 infants did
not have a scan done by day 3.
Table 2 DiVerence between two observers for intracranial ventricular measurements
All but two babies had unequal right and left
Intraclass thalamo-occipital distance measurements. The
Mean (SD) of average Mean correlation median diVerence was 2.3 mm (interquartile
Measurement (mm) between measurements diVerence Variability coeYcient
range, 1.2 to 3.8). There were 18 infants with a
Right AHW 1.01 (0.57) 0.01 0.28 0.89 diVerence greater than 5 mm. At the time of
Left AHW 1.29 (0.83) 0.02 0.32 0.93
Right TOD 16.6 (3.8) 0.06 1.92 0.88 the scan, 54 infants were lying with their heads
Left TOD 17.6 (2.9) 0.23 1.94 0.80 on the side with the right side up, 61 with the
Third ventricle width 0.77 (0.29) 0.01 0.20 0.79
Fourth ventricle width 5.40 (0.73) 0.15 0.70 0.63 left side up (three were face up and two
Fourth ventricle length 5.55 (0.90) 0.02 1.22 0.38 unrecorded). The mean (SD) anterior horn
The average between measurements refers to the average of the mean of both repeated
width of the non-dependent ventricle was 1.3
measurements. (0.8) mm and for the dependent ventricle it
The mean diVerence refers to the average diVerence of the repeated measurements. was 1.2 (0.8) mm (p = 0.3). The mean (SD)
Variability refers to the standard deviation of the diVerences between repeated measurements.
AHW, anterior horn width; TOD, thalamo-occipital distance. thalamo-occipital distance of the non-
dependent ventricle was 16.7 (4.2) mm and for
INTRA-OBSERVER AND INTER-OBSERVER
the dependent ventricle it was 16.6 (3.9) mm
RELIABILITY
To assess intra-observer reliability the first 30 (p = 0.89). There was no eVect of head
measurements for each ventricle (done on position on size of the lateral ventricles. There-
infants in our study population) were repeated fore, data from both sides were pooled for all
by the same observer (MWD or MS). Usually, further analysis.
the optimal two dimensional image is frozen on Table 1 displays the ventricular dimensions
the ultrasound screen and the measurement according to sex. The only significant diVer-
taken. For the repeat measurement the image ence between the sexes was the mean thalamo-
was unfrozen, the ultrasound probe reapplied occipital distance, which was 1.9 mm longer in
to the infants head, the optimal image obtained boys. Because this diVerence is not clinically
again, and another measurement taken. significant, it is similar to the variability
Inter-observer reliability was assessed in a between observers (table 2), and there were no
separate population of infants (all < 33 weeks’ other diVerences between the sexes, the data
gestational age) not included in our study were combined for all further analysis.
population. Thirty infants had measurements Figures 6 to 10 show the scatter plots for the
performed by one observer and the measure- ventricular measurements according to
ments were then repeated by the second gestational age. Regression equations and coef-
observer who was blinded to the first observer’s ficients of determination (R2) are also shown.
data. These measurements were done by All measurements show little or no change with
MWD and MS. gestational age. The greatest degree of change
The average diVerence between measure-
with gestational age is seen in the fourth
ments should be close to zero and the variabil-
ventricle width, with an R2 of 0.124, indicating
ity between measurements is defined as the
standard deviation of the diVerences between that only 12% of this measurement is ac-
repeated measurements. The intraclass corre- counted for by gestational age. All the other
lation coeYcient as described by Jamart14 was measurements have much lower values for R2.
calculated for each variable and the strength of Because of the lack of change in ventricular
agreement scale of Brennan and Silman15 was measurements with gestational age (from 23 to
used for interpretation. The strength of agree- 32+6 weeks), measurements across these
ment or reliability was poor if the intraclass gestational age can be combined. Pooled data
correlation coeYcient was less than 0.20, fair if from both lateral ventricles, both sexes, and all
between 0.21 and 0.40, moderate if between gestational ages gives summary statistics with
0.41 and 0.60, good if between 0.61 and 0.80, mean and standard deviation, with appropriate
and very good if > 0.81. reference ranges, for all ventricular measure-
ments (table 3).
Results Tables 2 and 4 show the results of reliability
There were 225 infants less than 33 weeks’ testing. All mean diVerences are close to zero.
gestational age admitted to our unit during the The intra-observer agreement is very good for
study period. One hundred and twenty infants all measurements except the fourth ventricle
with a known gestational age (ranging from length, which is still good. The inter-observer
23+1 to 32+6 weeks) had their intracranial reliability is very good for anterior horn width
ventricles measured. The mean (SD) birth- and right thalamo-occipital distance, good for
weight was 1222 (405) g and the mean (SD) left thalamo-occipital distance, third ventricle
gestational age was 29.2 (2.5) weeks. The width, and fourth ventricle width, but only
gestational age assessment was based upon an moderate for fourth ventricle length.
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Reference ranges for intracranial ventricles in preterm neonates F221

5 9

Fourth ventricle width (mm)

8

Anterior horn width (mm)

4
7
3 6
5
2
4
1 3
2
0
1
–1 0
22 23 24 25 26 27 28 29 30 31 32 33 34 22 23 24 25 26 27 28 29 30 31 32 33 34
Gestational age (weeks) Gestational age (weeks)
Figure 6 Anterior horn width (AHW) by gestational age Figure 9 Fourth ventricle width (4thVW) by gestational
(GA) with fitted line plot (bold line) and 95% confidence age (GA) with fitted line plot (bold line) and 95%
intervals (thin lines). AHW (mm) = 0.71 + 0.019 × GA confidence intervals (thin lines). 4thVW
(weeks); R2 = 0.004. (mm) = 1.33 + 0.14 × GA (weeks); R2 = 0.124.
Thalamo-occipital distance (mm)

40 8

Fourth ventricle length (mm)

35 7
30 6
25 5
20 4
15
3
10
2
5
1
0
22 23 24 25 26 27 28 29 30 31 32 33 34 0
22 23 24 25 26 27 28 29 30 31 32 33 34
Gestational age (weeks)
Gestational age (weeks)
Figure 7 Thalamo-occipital distance (TOD) by
gestational age (GA) with fitted line plot (bold line) and Figure 10 Fourth ventricle length (4thVL) by gestational
95% confidence intervals (thin lines). TOD age (GA) with fitted line plot (bold line) and 95%
(mm) = 13.5 + 0.109 × GA (weeks); R2 = 0.005. confidence intervals (thin lines). 4thVL
(mm) = 4.24 + 0.017 × GA (weeks); R2 = 0.002.
2.5
and serial measurements are valuable in
Third ventricle width (mm)

2 following the progression of dilatation.

1.5
1
0.5
0
–0.5
22 23 24 25 26 27 28 29 30 31 32 33 34
Gestational age (weeks)
Figure 8 Third ventricle width (3rdVW) by gestational
age (GA) with fitted line plot (bold line) and 95%
confidence intervals (thin lines). 3rdVW
(mm) = 0.064 + 0.033 × GA (weeks); R2 = 0.038.
Discussion
Ultrasound is the preferred method for assess-
ing ventricular size in infants.1 Objective meas-
urements are required for the initial diagnosis
of ventricular enlargement2 and are essential
for assessing subsequent changes in ventricular
size. Our study provides reference ranges for
the linear measurements of all four intracranial
ventricles in preterm infants from 23 to 33
weeks’ gestational age. This is the first study to
provide normal values for measurement of the
third and fourth ventricles and the thalamo-
occipital distance in preterm newborns. These
reference ranges can be used to diagnose
ventricular enlargement in the preterm infant,
The intraclass correlation coeYcient not
only takes into account the diVerence between
observations (by a single observer or two
diVerent observers), but also the variability
between subjects.14 All four ventricular meas-
urements are readily reproducible with mini-
mal intra-observer and inter-observer diVer-
ences. Only the measurement of the fourth
ventricle length is moderately unreliable on
measurement between observers. The axial
resolution of the ultrasound probe is approxi-
mately 0.2 mm, which is less than the degree of
diVerence seen within and between observers.
The use of the thalamo-occipital distance to
determine enlargement of the occipital horn of
the lateral ventricles provides a more subtle
marker for ventriculomegaly because the oc-
cipital horn is the first to enlarge in post-
haemorrhagic ventricular dilatation.16 17 The
measurement has been used in the fetus in the
prenatal diagnosis of hydrocephalus.18 Normal
values for the measurement of the third and
fourth ventricles combined with those for
lateral ventricles will also help in diVerentiating
between communicating and non-
communicating ventriculomegaly.
Our results for anterior horn width are con-
sistent with a previous study by Perry et al,13
which established an upper limit of 3 mm in
infants from 26 to 42 weeks’ gestational age
(compared with our upper limit of normal of
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F222 Davies, Swaminathan, Chuang, Betheras

Table 3 Pooled data for intracranial ventricular dimensions from 23 to 32 weeks’ diYcult, even in a large tertiary centre.
gestational age However, the measurements from these infants
Measurement (mm) Mean SD Normal range
do contribute to the overall regression equa-
tion, and the measurements obtained are
Anterior horn width (n = 240) 1.27 0.81 0–2.9 entirely consistent with the remainder of the
Thalamo-occipital distance (n = 239) 16.7 4.0 8.7–24.7
Third ventricle width (n = 120) 1.07 0.74 0–2.6 data. These results cannot be used to derive
Fourth ventricle width (n = 103) 5.37 1.03 3.3–7.4 conclusions on ventricular size in infants
Fourth ventricle length (n = 102) 4.74 1.09 2.6–6.9 greater than 33 weeks’ gestational age. The
. gestational age range from 23 to 33 weeks was
studied because it is this population of babies
Table 4 DiVerence between two measurements by a single observer for intracranial that has routine cranial ultrasounds soon after
ventricular measurements
birth, because they are most at risk of intraven-
Intraclass tricular haemorrhage and periventricular leu-
Mean (SD) of average Mean correlation komalacia. This is also the population that is
Measurement (mm) between measurements diVerence Variability coeYcient
most at risk for developing post-haemorrhagic
Right AHW 1.52 (0.81) 0.01 0.21 0.97 ventriculomegaly.
Left AHW 1.70 (0.98) 0.01 0.25 0.97
Right TOD 16.5 (3.9) 0.21 0.99 0.97
Asymmetry of the lateral ventricles occurs
Left TOD 18.1 (4.3) 0.19 1.20 0.96 frequently in neonates.21 It is a commonly held
Third ventricle width 1.24 (0.32) 0.0 0.16 0.89 belief that asymmetry of the lateral ventricles
Fourth ventricle width 5.49 (0.91) 0.03 0.32 0.94
Fourth ventricle width 5.19 (0.89) 0.02 0.60 0.80 could be the result of the position of the
infant’s head at the time of the cranial
The average between measurements refers to the average of the mean of both repeated ultrasound, accounted for by the shift of
measurements.
The mean diVerence refers to the average diVerence of the repeated measurements. cerebrospinal fluid from the non-dependent to
Variability refers to the standard deviation of the diVerences between repeated measurements. the dependent lateral ventricle. We have shown
AHW, anterior horn width; TOD, thalamo-occipital distance. that head position has no eVect on the
2.9 mm). Our thalamo-occipital distance data diVerence in measurements between the non-
are similar to fetal data across the same dependent and dependent lateral ventricles.
gestational age range.18 Similarly, the sex of the infant has little
There is little change in the ventricular influence on ventricular size.
dimensions from 23 to 32 weeks’ gestational
age. The greatest degree of change with
Conclusions
gestational age is seen in the fourth ventricle
References ranges for the measurement of the
width, with only 12% of this measurement
intracranial ventricles in preterm infants from
accounted for by gestational age. This slight
23 to 33 weeks’ gestational age are provided.
increase in fourth ventricle width is probably
These measurements can be used in the
more related to cerebellar growth, as measured
diagnosis and assessment of ventricular en-
by transverse cerebellar diameter, which shows largement in preterm infants less than 33
close correlation with gestational age.19 The weeks’ gestational age. All measurements have
ventricles are not structures that will grow in good intra-observer and inter-observer reliabil-
the usual sense, because they are merely fluid ity. Head position at the time of the scan does
filled spaces. Growth is accounted for by the not influence the asymmetry of the lateral ven-
laying down of tissue substrate or an increase in tricular measurements. The infant’s sex does
cell size or number and this is not applicable to not significantly influence ventricular size.
the ventricles. Therefore, it is no surprise that
the ventricles do not “grow” as gestational age
1 Rennie JM. Enlarged cerebral ventricles. In: Neonatal
increases, although the surrounding brain cerebral ultrasound. Cambridge: Cambridge University
does. Other investigators have shown similar Press, 1997:155–69.
2 Shackleford GD. Neurosonography of hydrocephalus in
results with regard to measurements relating to infants. Neuroradiology 1986;28:452–62.
the anterior horns. Sauerbrei and colleagues6 3 Levene MI. Measurement of the growth of the lateral
ventricles in preterm infants with real time ultrasound.
showed no increase in ventricular index or Arch Dis Child 1981;56:900–4.
anterior horn width from 25 to 35 weeks, and 4 Allan WC, Holt PJ, Sawyer LR, Tito AM, Meade SK. Ven-
tricular dilatation after neonatal periventricular-
Perry and colleagues13 also showed no change intraventricular hemorrhage. Natural history and
in anterior horn width from 26 to 42 weeks. In therapeutic implications. Am J Dis Child 1982;136:589–
93.
other studies, conducted over large gestational 5 London DA, Carroll BA, Enzmann DR. Sonography of ven-
age ranges, changes in dimension of the tricular size and germinal matrix hemorrhage in premature
infants. AJNR Am J Neuroradiol 1980;1:295–300.
anterior horns seem to show little increase with 6 Sauerbrei EE, Digney M, Harrison PB, Cooperberg PL.
age until 30–32 weeks’ gestational age.3 20 Ultrasonic evaluation of neonatal intra-cranial hemor-
rhage and its complications. Radiology 1981;139:677–85.
Saliba et al measured the area of the lateral 7 Skolnick ML, Rosenbaum AE, Matzuk T, Guthkelch AN,
ventricles and found that they did not increase Heinz ER. Detection of dilated cerebral ventricles in
infants: a correlative study between ultrasound and
with gestational age.11 There are no other neo- computed tomography. Radiology 1979;131:447–51.
natal data with which to compare the thalamo- 8 Levene MI, Starte DR. A longitudinal study of post-
haemorrhagic ventricular dilatation in the newborn. Arch
occipital distance, third ventricle width, fourth Dis Child 1981;56:905–10.
ventricle width, or fourth ventricle length 9 Helmke K, Winkler P. Sonographisch ermittelte normwerte
des intrakraniellen ventrikelsystemes im ersten lebensjahr.
measurements. Monatsschr Kinderheilkd 1987;135:148–52.
The values need to be interpreted with cau- 10 Poland RL, Slovis TL, Shankaran S. Normal values for ven-
tricular size as determined by real time sonographic tech-
tion at the lower end of the gestational age niques. Pediatr Radiol 1985;15:12–14.
spectrum (< 25 weeks’ gestational age) be- 11 Saliba E, Bertrand P, Gold F, Vaillant MC, Laugier J. Area
cause of the small number of infants. Recruit- of lateral ventricles measured on cranial ultrasonography
in preterm infants: reference range. Arch Dis Child
ment of infants at the margins of viability is 1990;65:1029–32.
 Downloaded from fn.bmj.com on July 7, 2014 - Published by group.bmj.com
Reference ranges for intracranial ventricles in preterm neonates
12 Papile L, Burstein J, Burstein R, KoZer H. Incidence and
evolution of subependymal and intraventricular hemor-
rhage: a study of infants with birth weights less than
1,500 gm. J Pediatr 1978;92:529–34.
13 Perry RNW, Bowman ED, Roy RND, de Crespigny LC.
Ventricular size in newborn infants. J Ultrasound Med
1985;4:475–7.
14 Jamart J. Assessing observer variability. BMJ 1992;305:313–
12.
15 Brennan P, Silman A. Statistical methods for assessing
observer variability in clinical measures. BMJ
1992;304:1491–4.
16 Brann BS, Qualls C, Wells L, Papile L. Asymmetric growth
of the lateral cerebral ventricle in infants with posthemor-
rhagic ventricular dilatation. J Pediatr 1991;118:108–12.
17 Silverboard G, Horder MH, Ahmann PA, Lazzara A,
Schwartz JF. Reliability of ultrasound diagnosis of
F223
intracerebral hemorrhage and posthemorrhagic hydro-
cephalus: comparison with computed tomography. Pediat-
rics 1980;66:507–14.
18 Monteagudo A, Haratz-Rubinstein N, Timor-Tritsch IE.
Biometry of the fetal brain. In: Timor-Tritsch IE,
Monteagudo A, Cohen HL, eds. Ultrasonography of the pre-
natal and neonatal brain. Connecticut: Appleton and
Lange, 1996:89–146.
19 Swaminathan M, Davies MW, Davis PG, Betheras FR.
Transverse cerebellar diameter on cranial ultrasound scan
in preterm neonates in an Australian population. J Paediatr
Child Health 1999;35:346–9.
20 Liao M, Chaou W, Tsao L, Nishida H, Sakanoue M. Ultra-
sound measurement of the ventricular size in newborn
infants. Brain Dev 1986;8:262–8.
21 Shen E, Huang F. Sonographic finding of ventricular asym-
metry in neonatal brain. Arch Dis Child 1989;64:730–44.
 Downloaded from fn.bmj.com on July 7, 2014 - Published by group.bmj.com

Reference ranges for the linear dimensions of

the intracranial ventricles in preterm neonates
M W Davies, M Swaminathan, S L Chuang, et al.

Arch Dis Child Fetal Neonatal Ed 2000 82: F218-F223

doi: 10.1136/fn.82.3.F218

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